Epilepsy
Essential Hypertension
Cancer/Oncology
Chronic Fatigue Syndrome
Chronic Fibromyalgia
Claustrophobia
Dysphonia
Gagging
Headaches (Tension/Migraine/Histamine)
Indigestion/GERD from Hiatus
Hernia
Immune System Disorders
Insomnia
I.B.S./Chron s Disease
Litigation Stress Syndrome
Menstrual Disorders
Memory Problems
Multiple Sclerosis
Muscle Spasm or Tension
Nausea & vomiting
Needlephobia
Neurodermatitis
Panic Attacks
Pain Management
Shy Bladder
Sleeping Disorders
Stress
Tinitus
TMJ Cranio-facial Pain Syndrome
Torticollis
Vertigo
1999
Mauer, Magaly H.; Burnett, Kent F.; Ouellette, Elizabeth Anne; Ironson, Gail H.; Dandes, Herbert M. (1999). Medical hypnosis and orthopedic hand surgery: Pain perception, postoperative recovery, and therapeutic comfort. International Journal of Clinical and Experimental Hypnosis, 47 (2), 144-161.
Orthopedic hand-surgery patients experience severe pain postoperatively, yet they must engage in painful exercises and wound care shortly after surgery; poor patient involvement may result in loss of function and disfigurement. This study tested a hypnosis intervention designed to reduce pain perception, enhance postsurgical recovery, and facilitate rehabilitation. Using a quasi-experimental research design, 60 hand-surgery patients received either usual treatment or usual treatment plus hypnosis. After controlling for gender, race, and pretreatment scores, the hypnosis group showed significant decreases in measures of perceived pain intensity (PPI), perceived pain affect (PPA), and state anxiety. In addition, physician’s ratings of progress were significantly higher for experimental subjects than for controls, and the experimental group had significantly fewer medical complications. These results suggest that a brief hypnosis intervention may reduce orthopedic hand-surgery patients’ postsurgical PPI, PPA, and anxiety; decrease comorbidity; and enhance postsurgical recovery and rehabilitation. However, true experimental research designs with other types of controls must be employed to determine more fully the contribution of hypnosis to improved outcome.
1998
Eimer, Bruce; Freeman, Arthur (1998). Pain management psychotherapy: A practical guide. New York NY: John Wiley & Sons, Inc..
“Pain Management Psychotherapy” (PMP) provides a clear and methodical look at pain management psychotherapy beginning with the initial consultation and work-up of the patient and continuing through termination of treatment. It is a thoughtful and thorough presentation that covers methods for psychologically assessing the chronic pain patient (structured interviews, pain assessment tests and rating scales, instruments for evaluating beliefs, attitudes, pain behavior, disability, depression, anxiety, anger and alienation), treatment planning, cognitive-behavioral therapy techniques, and a range of hypnotic approaches to pain management. The book covers both traditional (cognitive and behavior therapy, biofeedback, assessing hypnotizability, choice of inductions, designing an individualized self-hypnosis exercise) as well as newer innovative techniques (e.g., EMDR, pain-relief imagery, hypno-projective methods, hypno-analytic reprocessing of pain-related negative experiences). An extensive appendix reproduces in their entirety numerous forms, rating scale, inventories, assessment instruments, and scripts.
The senior author, Bruce Eimer, states in his online comments on Amazon.com that “most therapists hold the belief that ‘real’ chronic pain patients are quite impossible to help. This book attempts to dispel these misguided beliefs by providing a body of knowledge, theory, and techniques that have proven value in understanding and relieving chronic physical pain.” He also states that “the challenge for the therapist is to persuade the would-ne patient/client that he or she has something to offer that can help take way pain and bring back more pleasure. This challenge is negotiated through the therapeutic relationship. However, the therapist just can’t be ‘warm, accepting, non-judgmental and empathic’. The therapist must also have knowledge and skills relevant to relieving pain. Only then can the therapist impart such knowledge, and in teaching these skills to the pain patient, help the patient become something of a ‘self-therapist’. . . I dedicate this book to everyone who wants to find ways to make living with pain more comfortable, and to the ongoing search for better ways to relieve pain.”
1997
Sapp, Marty; Farrell, Walter C. Jr.; Johnson, James Jr.; Kirby, Renee Sartin; Pumphrey, Khyana K. (1997). Hypnosis: Applications for rehabilitation counselors. Journal of Applied Rehabilitation Counseling, 28 (2), 43-49.
This article describes how the rehabilitation counselor can employ hypnosis. Hypnosis can be employed as a useful tool in working with individuals
who have experienced a disability. It can be used to reduce anxiety and stress
related to returning to work; it can help clients learn to reduce stress and to
modify themselves, even if their environments cannot change; and it can be used to increase the self-esteem of clients with disabilities.
1996
Dane, Joseph R. (1996). Hypnosis for pain and neuromuscular rehabilitation with multiple sclerosis: Case summary, literature review, and analysis of outcomes. International Journal of Clinical and Experimental Hypnosis, 44 (3), 208-231.
Videotaped treatment sessions in conjunction with 1-month, 1-year, and 8-year follow-up allow a unique level of analysis in a case study of hypnotic treatment for pain and neuromuscular rehabilitation with multiple sclerosis (MS). Preparatory psychotherapy was necessary to reduce the patient’s massive denial before she could actively participate in hypnosis. Subsequent hypnotic imagery and posthypnotic suggestion were accompanied by significantly improved control of pain, sitting balance, and diplopia (double vision), and a return to ambulatory capacity within 2 weeks of beginning treatment with hypnosis. Evidence regarding efficacy of hypnotic strategies included (a) direct temporal correlations between varying levels of pain relief and ambulatory capacity and the use versus nonuse of hypnotic strategies, (b) the absence of pharmacological explanations, and (c) the ongoing presence of other MS-related symptoms that remained unaltered. In conjunction with existing literature on hypnosis and neuromuscular conditions, results of this case study strongly suggest the need for more detailed and more physiologically based studies of the phenomena involved. – Journal Abstract
1993
Everett, John J.; Patterson, David R.; Burns, G. Leonard; Montgomery, Brenda; Heimbach, David (1993). Adjunctive interventions for burn pain control: Comparison of hypnosis and Ativan. Journal of Burn Care and Rehabilitation, 14, 676-683.
Thirty-two patients hospitalized for the care of major burns were randomly assigned to groups that received hypnosis, lorazepam, hypnosis with lorazepam, or placebo controls as adjuncts to opioids for the control of pain during dressing changes. Analysis of scores on the Visual Analogue Scale indicated that although pain during dressing changes decreased over consecutive days, assignment to the various treatment groups did not have a differential effect. This finding was in contrast to those of earlier studies and is likely attributable to the low baseline pain scores of subjects who participated. A larger number of subjects with low baseline pain ratings will likely be necessary to replicate earlier findings. The results are argued to support the analgesic advantages of early, aggressive opioid use via PCA or through careful staff monitoring and titration of pain drugs.
1992
Alden, Phyllis (1992, October). The use of hypnosis in the management of pain on a spinal injuries unit. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES 1:
[Author is at Royal National Hospital in England]
To have a spinal injury is one of the most devastating injuries that can happen, reducing you suddenly from a normal life to situation of loss of control, helplessness, etc.- -with nothing to say about what is being done in surgery or other aspects of treatment.
In UK patients come for acute care and rehabilitation all in one place. Over 2 1/2 yrs we had 46 referrals. 7 refused hypnosis (“witch doctoring”). 30 benefitted.
Appel, Philip R. (1992). Performance enhancement in physical medicine and rehabilitation. American Journal of Clinical Hypnosis, 35, 11-19.
Performance enhancement or mental practice is the “symbolic rehearsal of a physical activity without any gross muscular movements” to facilitate skill acquisition and to increase performance in the production of that physical activity. Performance- enhancement interventions have been well known in the area of sports psychology and medicine. However, clinical applications in physical medicine and rehabilitation have not flourished to the same extent, though the demand for improved physical performance and the acquisition of various motor skills are as important. In this paper I will describe how hypnosis can potentiate mental practice, present a model of mental practice to enhance performance, and describe how to help patients access an ideal performance state of consciousness.
Weber, Alison Mary (1992, October). Hypnosis with brain-injured patients. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES 1:
INTRODUCTION. The purpose of this paper is a consciousness-raising one. The use of hypnosis with brain-injured people has been relatively neglected with respect to its potential benefit for the patients themselves and also for increasing our knowledge of hypnotic ability. Occasional reports concerning the use of hypnosis with brain-injured patients have appeared (e.g., Crasilneck & Hall, 1970 & 1975; LaClave & Blix, 1989; Manganiello, 1986). However, clinicians often assume that such patients are not able to utilise hypnotic techniques. This assumption appears to derive from three mistaken beliefs: 1. The belief that hypnotic trance ability requires an intact brain. Actually, a fully intact brain is not necessary for entering a hypnotic trance. 2. The belief that brain damage means that the person is totally mentally incompetent, a “vegetable.” In reality there are degrees of brain injury that vary from coma or vegetative state through to relatively mild changes in ability that may not be immediately obvious yet significantly impact the person’s functioning in everyday life. 3. The belief that brain-damaged individuals are identical with respect to their type of cognitive disability. In actual fact, the cognitive and other effects of brain injury vary according to location within the brain’s functional systems.
CASE EXAMPLES. All four cases are people of apparently average or better ability prior to injury as judged from their educational and vocational history. Before discussing these examples, I should point out that the basic induction technique used has generally been the same one that I use with non-brain-injured people. This technique is one that encourages mental and physical relaxation and a mental attitude of passivity and dissociation (Weber, 1981). All were taught to use self-hypnosis as a means of making the benefits available as needed. No hypnotizability scales were used and the issue of using such scales with brain-injured people will be commented upon later.
CASE 1 is a 39 year-old man who fell hitting his head and sustaining a closed head injury. The main effect of that injury was severe slowing of information processing speed. This problem is a common one in cases of closed head injury , is thought to be related to diffuse microscopic axonal injury, and causes experiences of mental fatigue, overload, and stress. The mentally passive, relaxed dissociative state offered through hypnosis helps prevent and reduce these overload problems. In this patient’s case, his use of the hypnotic technique enabled him to increase his daily activity level from one of mainly sleeping and resting in darkened rooms to one that included a live-in relationship with his former wife and engaging in hobbies and social activities.
CASE 2 is a 22 year-old man who had a malformation of blood vessels in the left temporoparietal area of the brain. He was undergoing surgical correction of this malformation when it hemorrhaged and he was left aphasic and paralysed down the right side of his body. At the time of hypnotic treatment, he had switched to using his left hand for writing, was able to walk though with a limp, and was able to converse intelligibly but with some underlying language difficulties. He particularly complained of right-sided pain and general numbness of his body. Post-hypnotic suggestions about his body feeling normal and solid together with imagery related to swimming were effective in eliminating the pain and reducing the numbness so that he experienced his body as comfortable and “more normal.” He was so comfortable physically that he started earning a living by mowing lawns.
CASE 3 is a 40 year-old man who fell at work, sustained a closed head injury, was unconscious for 1.5 hours, and had no recall of events for 2.5 days after injury. Five years later he still showed a very disorganised and fragmented memory that was suggestive of frontal system dysfunction. He was also able to recall very little of his life prior to injury and this lack of autobiographical memory was very disconcerting to himself and to his family. He was able to benefit from post-hypnotic suggestions concerning his ability to form associations to pictures in the family photo album. These associations were then used as a basis for his making a written autobiographical outline to which he could refer as needed.
CASE 4 is a 47 year-old man who was showing subtle changes in personality over about 10 years, suddenly had a severe grand mal seizure during which he stopped breathing, and was found to have a large meningioma arising from the falx and extending bilaterally over the top of his brain. There was also evidence of recent hemorrhage within the tumor. The tumor was surgically removed but due to its previous pressure on the brain and to possible anoxia when he stopped breathing, he was left with cognitive problems of poor planning and organizing, slowed mental processing, and memory problems secondary to these other problems. He also showed emotional lability and disinhibition and physical problems that at first involved paralysis but later improved to leg weakness and spasticity and arm weakness and incoordination. Hypnotic techniques helped this patient in several ways: (a) Mental relaxation and dissociation resulted in better emotional control and some relief of the painful knotting of his leg muscles. (b) Age regression was successful in improving his manual coordination for the purpose of accordion playing, an activity of great emotional significance to this patient and his wife. During regression to age 15 years, he reported a twitching of his arm muscles (also observed by the therapist), a feeling that his arms and hands could “move more freely and flexibly as if a resistant force had been removed,” and a feeling like “electrical recharging and reconnecting.” His accordion playing noticeably improved from about 15 percent to about 90 percent competency and he was able to play again from memory for the first time since his surgery. (c) Post-hypnotic suggestions about his brain connecting to his leg muscles and these muscles working smoothly resulted in his being able to walk around the block without cramping for the first time since his surgery and a few weeks later he was able to walk for four or five hours in the mall instead of being limited to 30 minutes. (d) The patient also reported generally improved well-being as “having more energy, like another veil has been taken off so that things look sharper and more in focus.”
These four cases represent just a few of the ways brain-injured people can be helped by hypnosis. There are sure to be more ways just as there are for people with normal brains. In order to adapt hypnotic techniques to the needs of brain-injured people, some understanding of their particular brain-function problems is important.
HYPNOSIS AND BRAIN FUNCTION. Because of time limits only a very quick and simplified overview of brain function can be provided but it should serve to give a general “feel” for a neuropsychological orientation to hypnosis with brain-injured people. It is based partly on Luria’s model of brain function (Luria, 1973).
1. Arousal and Some Physiological Functions. These functions involve the brain stem. Arousal functions include sleeping/waking, consciousness/coma, and level of general alertness. The brainstem also controls various physiological functions such as breathing, heart rate, and blood pressure.
2. Knowledge. Information from auditory, visual, and somesthetic path ways generally goes to the posterior half of the brain on the side opposite that of stimulus presentation. There are three levels of processing: (a) Primary processing involving initial registration and consciousness of stimuli; (b) Secondary perceptual elaboration of sensory input so that it makes perceptual sense. For example, in the visual modality the lines and colors registered in the primary area are organized into cohesive shapes in the secondary area. (c) Tertiary processing involves integration of input across modalities, for example, the ability to associate an auditorally heard word with the visually presented object it symbolizes.
3. Action. This aspect of brain function includes both motor and mental performance and embraces physical action, speech, and active thinking such as generating ideas and problem-solving. It is located in the anterior half of the brain and also has three levels: (a) Primary control of discrete muscle groups which mainly involves one side of the brain controlling the opposite side of the body; (b) Secondary areas underlie the ability to organize discrete muscle groups into a sequence such as brushing one’s teeth; (c) Tertiary executive areas which are critical to the generation of purposive behaviour, goals, plans, self-monitoring and adaptation.
4. Lateralization of Cognitive Function. The two cerebral hemispheres are usually specialized in the following way for most right- handed people: (a) Left Hemisphere language; symbolic, analytic, sequential type thinking; and
probably motor planning. (b) Right Hemisphere visuospatial, melodic, holistic, synthetic thinking.
5. Information Processing Speed. This aspect of mental function seems to depend on the axonal connections that form the white matter of the brain. Speed of information processing refers to the amount of information that can be attended to and processed within a given amount of time and includes both external stimuli like sights and sounds and also internal ones such as thoughts and memories.
6. New Learning and Memory. This feature of our abilities involves moving initially registered information into long term storage. The hippocampus is particularly critical in this process. The thalamus is thought to play a part in cued recall. General strategies for encoding and retrieval are probably influenced by frontal system function.
7. Emotional and Motivational Function. These functions appear to relate to the limbic system and basomedial frontal areas of the brain. These areas influence emotional intensity, emotional and social self-control, and motivation to initiate action.
8. Attention. Attentional function involves several brain areas. The brainstem is responsible for general arousal and level of alertness, white matter connections contribute to how much information a person can attend to and process within a given time, and the frontal cortex and its connections direct and organize the purposive focus of attention.
Any given mental or behavioral ability depends upon a complex system of brain areas and levels of processing. The effects of brain injury vary according to location and severity of damage, and also the person’s pre-injury condition and life style.
Obviously, the induction and suggestion techniques of hypnosis need to be based upon a neuropsychological understanding of the patient’s cognitive strengths and weaknesses. These factors also need to be considered when interpreting hypnotizability scores on standard scales and perhaps special scales need to be devised for work with such patients. The most common cognitive deficits encountered when working with brain- injured patients in the post-acute rehabilitation programs with which I have been associated have been those impacting memory, information processing speed, and executive function. Specific comments about these areas of deficit as they impact hypnosis are now given
Memory. A person with a defective ability to store new information (related to hippocampal dysfunction) is going to do well with post-hypnotic suggestions of amnesia but is probably not going to recall the items even when the amnestic suggestion is removed or if positive post-hypnotic suggestions are given. The patient with thalamic based memory difficulty may later be able to recall information but only provided a cuing structure of prompts or reminders is built into the suggestions. Whether or not memory ability in those with organically based memory deficit can be enhanced through hypnosis remains unclear. The patient presented earlier whose autobiographical memory difficulties were helped by hypnotic techniques did not have a storage problem per se but rather a very disorganized memory that probably stemmed from frontal type problems.
Information Processing Speed. Reduced speed of processing may necessitate giving instructions more slowly or in such a repetitive and redundant manner that some gaps in the patient’s registering what is said don’t matter. It is also important for such patients not to mentally overload them. For example, case #1 benefitted from the mental relaxation/ dissociation aspects of hypnosis and was able to mentally block out noise to which he was hypersensitive but the mental effort involved in such blocking-out resulted in his feeling mentally exhausted and stressed.
Executive Function. Patients with frontal system dysfunction show some deficits that are similar to hypnotic phenomena in people without brain dysfunction. From this point of view, they may be the most promising group to work with to clarify the nature of hypnosis. The hypnotized patient’s responses in conforming to suggestion resemble the stimulus-bound and concrete focus and time-distortive aspects of frontally dysfunctional behavior and perhaps also its confabulatory tendencies. The frontal patient may also show a dissociation between knowing and doing that is similar to the split reported by some people in being aware of and observing their own behavior at the same time as they respond to hypnotic suggestions. There is a sense in which the hypnotist acts as the “frontal lobes” of the hypnotized person, giving direction to their perceptions and behavior. The similarities between the two groups certainly invite further exploration and research.
References:
Crasilneck, H. B., & Hall, J. A. (1970) The use of hypnosis in the rehabilitation of complicated vascular and post-traumatic neurological patients. International Journal of Clinical and Experimental Hypnosis, 18, 145-159.
Crasilneck, H. B., & Hall, J. A. (1975) Hypnosis in neurological problems and rehabilitation. In H. B. Crasilneck & J. A. Hall, Clinical hypnosis: Principles and applications. New York: Grune & Stratton, pp. 203-222.
LaClave, L. J., & Blix, S. (1989) Hypnosis in the management of symptoms in a young girl with malignant astrocytoma: A challenge to the therapist. International Journal of Clinical and Experimental Hypnosis, 37, 6-14.
Luria, A. R. (1973) The Working Brain: An introduction to neuropsychology. Harmondsworth (UK): Penguin.
Manganiello, A. J. Hypnotherapy in the rehabilitation of a stroke victim. A case study. American Journal of Clinical Hypnosis, 29, 64-68.
Weber, A.M. (1981) Facilitation of dissociation in relation to mental relaxation and hypnosis. Australian Journal of Clinical and Experimental Hypnosis, 9, 101-102.
Hinshaw, Karin E. (1991). The effects of mental practice on motor skill performance: Critical evaluation and meta-analysis. Imagination, Cognition and Personality, 11, 3-35.
21 studies that met the criteria of having both an adequate control and a mental practice alone group were included. The 44 separate effect sizes resulted in an overall average effect size of .68 (SD = .11) indicating that there is a significant benefit to performance of using mental practice over no practice. A series of General Linear Models revealed that the use of “internal” imagery produced a larger average effect size than the use of “external” imagery, and that mental practice sessions of less than one minute or between ten and fifteen minutes in length produced a larger average effect size than sessions of three to five minutes in length. These findings suggest the complexity of the relationship between variables that influence mental practice.
1991
Sapp, Marty (1991, August). The effects of hypnosis in reducing anxiety and stress in adults with neurogenic impairment. [Paper] Presented at the annual meeting of the American Psychological Association, San Francisco.
A repeated measures design was utilized to investigate the effects of hypnosis in reducing anxiety and stress in 16 adults with neurogenic impairment. Seven sessions were used to measure the efficacy of hypnosis. Session one was used to obtain a baseline level of anxiety and stress and to initiate hypnosis. Sessions three and six were used to obtain repeated measures of these emotions. Sessions two, four, and five were the treatment sessions. Session seven was used to conduct a four week follow-up on the effects of hypnosis. Levels of anxiety were measured by the State-Trait Anxiety Inventory, while stress was measured by the State-Trait Anger Expression Inventory. The results indicated a statistically significant decrease in anxiety and stress. Hypnosis also significantly increased levels of self-esteem. Finally, follow-up data demonstrated that the treatment gains were maintained.
NOTES 1:
Hypnotizability was not related to treatment outcome. The average Barber Susceptibility Scale score was 3, which indicates that the subjects were fairly low in hypnotizability level.
1990
Appel, Philip R. (1990). Clinical applications of hypnosis in the physical medicine and rehabilitation setting: Three case reports. American Journal of Clinical Hypnosis, 33 (2), 85-93.
Hypnosis is useful in the rehabilitation setting to help patients master skills, to increase their sense of self-efficacy and self-esteem and, in general, to facilitate and accelerate their rehabilitation program. I used hypnosis with three patients where patient behaviors and beliefs were interfering with the rehabilitation treatment goals set by the patient and the health care team. Collectively, these cases demonstrate the use of hypnotic techniques in diagnosing and treating problems with patient compliance and assisting patients to gain greater benefit from their rehabilitation regimen. – Journal Abstract
1990
Macfarlane, F. K.; Duckworth, M. (1990). The use of hypnosis in speech therapy: A questionnaire study. British Journal of Disorders of Communication, 25, 227-246.
NOTES 1:
Reports results of a survey of speech therapists trained in the use of hypnosis. The majority use hypnosis in treating voice or fluency disorders to achieve relaxation and encourage self-esteem and also in the treatment of acquired neurological disorders. Respondents were less inclined to use hypnosis with children. Problems encountered in the use of hypnosis are explored.
Holroyd, Jean; Hill, Alexis (1989). Pushing the limits of recovery: Hypnotherapy with a stroke patient. International Journal of Clinical and Experimental Hypnosis, 37, 189-191.
Hypnotherapy was used to assist recovery of left arm function following stroke in a 66-year-old woman. Treatment protocol is described, and results are discussed in terms of how hypnosis may facilitate voluntary motor movement. Recent literature on cortical changes in hypnosis and motor improvement during hypnosis is discussed in relation to the present results.
The patient was 6 months post-stroke and physicians did not expect much additional improvement. She improved despite the fact that she measured as a low hypnotizable on the Stanford Scale, Form C. However, she appeared very absorbed in the hypnotic imagery, and she was highly motivated and exhibited much hope or positive expectation. Also, the author notes that “remarkable improvements in brain functioning have been reported through the use of sophisticated behavioral technology,” (p. 124), as in the use of EEG biofeedback to treat untractable seizures (Sterman & Lanz, 1981).
In rehabilitation cases, hypnotic dissociation may enhance pain control during the performance of exercises; more vivid hypnotic imagery may facilitate mental rehearsal of movements; attitudes may be reframed using hypnotic suggestion; and focusing attention on bodily sensations may be enhanced with hypnosis. Hypnosis also may improve expectancy, reduce anxiety, increase hope, provide general relaxation (reducing involuntary spasticity), increase cerebral blood flow, or in other ways promote healing.
Research by Pajntar, Roskar, & Vodovnik (1985) has demonstrated improved motor response during hypnosis for patients with hemiparesis. They attributed EMG changes under hypnosis “to a facilitory influx from supraspinal motor centers. They hypothesized that new motor units of paretic muscles were being activated or that there was an increased recruitment of the motor units already active, and they suggested that relaxation of the spastic antagonist muscle permits the paralyzed muscle to move” (p. 125).
1988
Borgens, Richard B. (1988). Stimulation of neuronal regeneration and development by steady electrical fields. In Waxman, S. G. (Ed.), Functional recovery in neurological disease (47, pp. 547-564). New York: Raven Press.
At the end of the review, author notes that a combination of electromyography and computer modeling of agonist-antagonist, flexor-extensor muscle contraction patterns in the functional body parts of hemiparetic patients, artificially imposed on the paralyzed portions of the body using repetitive electrical stimulation to effect more normal movement, sometimes leads to functional recovery. Such recovery has been observed in some chronic cases of paralysis associated with head injury, stroke, and cerebral palsy. These clinical observations challenge the way we should view paralysis in general. Perhaps there are many redundant pathways in the CNS that will support certain kinds of functional return in the absence of the original pathways destroyed by trauma. Perhaps CNS-associated paralysis is a problem, at least in part, of too much competing signal in spared pathways, not one of impoverished signal. Can use of these neuronal pathways be entrained or retrained? Is the return of function in patients who experience repetitive functional electrical stimulation due to a reorganization within the CNS? These are exciting questions whose answers will possibly lead to our ability to further modify the plasticity of the brain and spinal cord.
[This would fit with the inhibition model of hypnosis, and with the high theta power findings during hypnosis, the implication being that hypnosis facilitates filtering out non-essential competing stimuli.]
Houge, Donald R.; Hunter, Robert E. (1988). The use of hypnosis in orthopaedic surgery. Contemporary Orthopaedics, 16, 65-68.
Some patients postpone or refuse indicated orthopaedic surgery because of fear or a medical contraindication to anesthesia. Clinical hypnosis previously has been used mainly as an adjunct to chemical anesthesia. However, hypnosis was shown to be entirely effective when used as the sole anesthesia in three of four orthopaedic cases. These four procedures included a radical head resection, the removal of a sideplate and Richard’s screw from the hip, and two cases of arthroscopic knee surgery. The preparation required for the surgery and the experiences of the patients during these procedures are described, and the kinds of patients most likely to benefit from the use of hypnosis in orthopaedic surgery are reviewed.
1983
Spiegel, David (1983). Hypnosis with medical/surgical patients. General Hospital Psychiatry, 5, 265-277.
The role of hypnosis as a tool in the treatment of problems commonly encountered among medical and surgical patients is examined. Hypnosis is defined as a change in state of mind far more akin to intense concentration than sleep. Diagnostic implications of differences in hypnotic responsivity are explored, and scales suitable for use in the clinic are examined. Uses of hypnosis in treating anxiety, pain, childbirth, psychosomatic symptoms, seizure disorders, neuromuscular dysfunction, and habits are described and evaluated. The phenomenon of hypnosis is presented as a means of exploring the mind-body relationship in a controlled fashion, providing information of diagnostic importance while at the same time allowing hypnotizable patients to intensify their concentration and interpersonal receptivity in the service of a therapeutic goal
1980
Erickson, Milton H. (1980). Innovative hypnotherapy. New York, NY: Irvington Publishers, Inc..
NOTES 1:
This fourth volume of four has 9 sections, with chapters as follows. I. General Introductions to Hypnotherapy
1. The applications of hypnosis to psychiatry
2. Hypnosis in medicine
3. Hypnotic techniques for the therapy of acute psychiatric disturbances in war
4. Hypnotic psychotherapy
5. Hypnosis in general practice
6. Hypnosis: Its renascence as a treatment modality
7. Hypnotic approaches to therapy II. Indirect Approaches to Symptom Resolution
8. A clinical note on indirect hypnotic therapy
9. The hypnotic and hypnotherapeutic investigation and determination of symptom- function
10. Experimental hypnotherapy in Tourette’s Disease
11. Hypnotherapy: The patient’s right to both success and failure
12. Successful hypnotherapy that failed
13. Visual hallucination as a rehearsal for symptom resolution III. Utilization Approaches to Hypnotherapy
14. Special techniques of brief hypnotherapy
15. Pediatric hypnotherapy
16. The utilization of patient behavior in the hypnotherapy of obesity: Three case reports
17. Hypnosis and examination panics
18. Experiential knowledge of hypnotic phenomena employed for hypnotherapy
19. The burden of responsibility in effective psychotherapy
20. The use of symptoms as an integral part of hypnotherapy
21. Hypnosis in obstetrics: Utilizing experimental learnings
22. A therapeutic double bind utilizing resistance
23. Utilizing the patient’s own personality and ideas: ‘Doing it his own way’ IV. Hypnotherapeutic Approaches to Pain
24. An introduction to the study and application of hypnosis for pain control
25. The therapy of a psychosomatic headache
26. Migraine headache in a resistant patient
27. Hypnosis in painful terminal illness
28. The interspersal hypnotic technique for symptom correction and pain control
29. Hypnotic training for transforming the experience of chronic pain V. Hypnotherapeutic Approaches in Rehabilitation
30. Hypnotically oriented psychotherapy in organic brain damage
31. Hypnotically oriented psychotherapy in organic brain disease: An addendum
32. An application of implications of Lashley’s researches in a circumscribed arteriosclerotic brain condition
33. Experimental hypnotherapy in a speech problem: A case report
34. Provocation as a means of motivating recovery from a cerebrovascular accident VI. Hypnotherapy with Psychotics
35. Hypnotherapy with a psychotic
36. Symptom prescription for expanding the psychotic’s world view VII. Sexual Problems Hypnotherapeutic Reorientations to Emotional Satisfaction
37. Posthypnotic suggestion for ejaculatio praecox
38. Psychotherapy achieved by a reversal of the neurotic processes in a case of ejaculatio praecox
39. Modesty: An authoritarian approach permitting reconditioning via fantasy
40. Sterility: A therapeutic reorientation to sexual satisfaction
41. The abortion issue: Facilitating unconscious dynamics perm itting real choice
42. Impotence: Facilitating unconscious reconditioning
43. Latent homosexuality: Identity exploration in hypnosis
44. Vasectomy: A detailed illustration of a therapeutic reorientation VII. Self-Exploration in the Hypnotic State: Facilitating Unconscious Processes and Objective Thinking
45. Pseudo-orientation in time as a hypnotherapeutic procedure
46. Facilitating objective thinking and new frames of reference with pseudo-orientation in time
47. Self-exploration in the hypnotic state
48. Self-exploration in trance following a surprise handshake induction